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T Inoue

Publications and source records attributed to T Inoue.

At least 91 records · Page 5Linked to original sources
PubMed1995

Prophylactic irradiation of para-aortic lymph nodes in carcinoma of the uterine cervix. A prospective randomized study.

PURPOSE: For assessment of the advantages and side effects of para-aortic lymph nodes irradiation under the evaluation by computer tomography, a prospective randomized study was started in 1986. The results for survival, local control and late complications are presented in the following. PATIENTS AND METHODS: From November 1986 to October 1990, 93 patients with cervical carcinoma were randomly allocated for treatment with either pelvic irradiation (pelvic group) or pelvic plus para-aortic lymph nodes irradiation (para-aortic group). Thirty-six patients underwent external irradiation and intracavitary therapy (RT arm) and 57 patients, extended radical hysterectomy and external irradiation (OP-RT arm). Para-aortic lymph nodes irradiation delivered 45 Gy in 1.8 Gy per day for 5 days per week through anterior-posterior fields. RESULTS: The 3-year cause specific survival rates were para-aortic group: 57% and pelvic group: 89% in RT arm group, and para-aortic group: 70% and pelvic group: 86% in OP-RT arm group. Differences for the 2 groups in each treatment arm were not significant. In pelvic failure, para-aortic lymph nodes metastases and distant metastases showed no statistically significant differences for the 2 groups in each treatment arm. In the para-aortic group, complications were more frequent than in the pelvic group (13/45 vs. 2/48, p < 0.025). As an enteric complication ileus was found in 7% (3/45) of the para-aortic group while 2% (1/48) in the pelvic group. Compression fractures of the lumber vertebral body were apparent in 9% (4/45) and 0%, respectively. CONCLUSION: Routine para-aortic lymph nodes irradiation delivered through anterior-posterior fields for high risk patients with cervical carcinoma is of limited value occurring to the high incidence of late complications and this treatment fails to improve no survival rates.

Adenocarcinoma↗
PubMed1995

Growth of parathyroid gland in uremic patients on maintenance hemodialysis.

High-resolution, real-time ultrasonography was performed in 245 uremic patients on maintenance hemodialysis and the growth of the enlarged parathyroid glands was compared with the clinical and biochemical signs during follow-up periods of 12 months. The total volume of the parathyroid glands was significantly correlated with the serum C-terminal parathyroid hormone (C-PTH; r = 0.379, p = 0.0001) and calcium levels (r = 0.252, p = 0.0224). After 12 months, the total volume of the enlarged parathyroid glands and serum C-PTH or calcium levels were correlated more closely than in the initial study (r = 0.615, p = 0.0001, and r = 0.489, p = 0.0002, respectively). Both the serum C-PTH levels and the total volume of the enlarged parathyroid glands increased significantly (p = 0.0001), while the ratio between the serum C-PTH levels and the volume of the parathyroid glands decreased significantly (p = 0.0001). There was no difference in the clinical and biochemical signs except for the serum aluminum levels between the patients with and without an increased gland volume. These results suggest that the growth of parathyroid glands may progress more rapidly than the increase in the serum PTH levels, independent of the serum calcium levels, in uremic patients on maintenance hemodialysis.

Adolescent↗
PubMed1995

Influence of serum phosphate on the efficacy of oral 1,25-dihydroxyvitamin D3 pulse therapy.

In patients with a moderate degree of renal insufficiency, restriction of dietary phosphate suppresses PTH secretion by increasing serum calcitriol. However, this may not operate in advanced renal failure. The present study was designed to evaluate the influence of serum phosphate levels on PTH secretion in oral 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] pulse therapy. 22 patients with secondary hyperparathyroidism [carboxy-terminal PTH (c-PTH) concentration: 19.5+/-13.9 ng/ml, mean +/-SD] received oral doses of 1,25(OH)2D3 (3.0-4.0 micrograms) twice a week, each at the end of hemodialysis, for 12 weeks. Doses of phosphate binders remained unchanged throughout this period. Patients were divided into two groups: group A (11 subjects) with mean serum phosphate levels of less than 6.0 mg/dl and group B (11 subjects) with levels of 6.0 mg/dl and above. There was no significant difference in the average corrected serum calcium levels. The reduction in serum intact PTH levels was greater in group A than in group B. A negative correlation (r = -0.48; p < 0.05) was observed between mean serum phosphate levels and the percent decrease in serum c-PTH levels. The findings of this study indicate an important role for dietary phosphate reduction in oral 1,25(OH)2D3 pulse therapy and suggest that serum phosphate reduction may play a part in suppressing PTH secretion through a mechanism independent of 1,25(OH)2D3 and plasma calcium levels.

Administration, Oral↗
PubMed1995

[Fracture threshhold of rheumatoid arthritis patients].

The Bone mass measurement had been difficult while the fracture risk of the rheumatoid arthritic patient had been depended on osteoporosis. Recently, the accuracy of bone mass measurement became reliable that the adequate data could be obtained from the patients. This study shows the fracture threshold of rheumatoid patients by obtaining the bone mass density of those who had been suffering from fracture by DEXA. Twenty two limbs of 21 female patients were affected, average age of 65 and duration of 18 years, and the sites of fracture were femoral neck in 9 cases and humeral neck in 4 cases (62% of the fracture). The BMD of the spine in these patients shows. 828 g/cm2 which was below -3.4 sd of the normal japanese female and thought to be a fracture threshold in RA patients. The risk factors of the fractures in RA were ADL in the limbs, history of total joints arthroplasty and low body mass index.

Activities of Daily Living↗
PubMed1995

[Effects of inhaled beclomethasone on height growth and bone metabolism in children with asthma].

To evaluate the influences of inhaled beclomethasone dipropionate (BDP), 7.3-30.9 (15.5 +/- 6.5) micrograms/kg/day, on bone metabolism and height growth, we performed a longitudinal study for 6 months in 34 children with asthma aged between 3 and 15 years. Bone mineral density estimated by digital image processing method (DIP) and serum level of osteocalcin did not show any significant change, but height growth was slightly suppressed in the patients who inhaled more than 15 micrograms/kg/day of BDP. We concluded that the decision to prescribe inhaled BDP should be made on the balance of the clinical effects and the improvement of quality of life against the possibility of side effects.

Administration, Inhalation↗
PubMed1995

Survival of spleen colony-forming units (CFU-S) of irradiated bone marrow cells in mice: evidence for the existence of a radioresistant subfraction.

Because of increasing evidence of heterogeneity in the hematopoietic stem cell compartments, the radiosensitivity of spleen colony-forming units (CFU-S) was reevaluated to ascertain whether the classical single exponential curve for a graded dose of radiation is applicable at higher doses of radiation, 400-600 cGy. Bone marrow cells (BMC) removed from mice immediately after death under anesthesia were irradiated in vitro. Great care was taken to exclude anoxic effects during irradiation and to avoid any possible effects in the recipient mice from injection of excessive numbers of BMC. By estimating the number of cells to be injected to produce numbers of colonies within the evaluation range of the assay, we obtained a radiation survival curve that appeared to have a multiphasic concave shape; the D0 value for the 400-600 cGy range was estimated to be about 275 cGy, whereas the D0 for the lower doses was 95 cGy, the same value as previously reported. The reason a single exponential survival curve was previously obtained after graded doses of radiation is discussed, and a comparison of those results with the present data from in vitro radiation is made. Lacking experimental evidence, we speculate that the major factor that determines the slope of the survival curve is the degree to which the stem cells are in their normal hematopoietic environment during the irradiation. The probable existence of a fraction surviving after an exposure to 600 cGy, estimated by the limiting dilution assay, was about 1 per 2 x 10(6) BMC. Such radio-insensitive CFU-S appear to be primitive CFU-S, which can contribute materially to the long-term survival of lethally irradiated bone marrow recipients.

Animals↗
PubMed1995

[Successful treatment of an infected pseudoaneurysm of the ascending aorta with omental transfer--a case report].

The formation of pseudoaneurysm is an uncommon complication of after coronary artery bypass grafting (CABG). We report a 66-year-old man in whom an anastomotic pseudoaneurysm of the ascending aorta derived from mediastinitis after repeat CABG. At operation, the pseudoaneurysm was revealed to be involved in the proximal anastomotic site of a saphenous vein graft to the RCA. The aneurysm was resected and the defect was repaired with woven dacron patch under deep hypothermic circulatory arrest. In addition, omental transposition was performed to treat mediastinitis radically. Debris of the pseudoaneurysm grew methicillin-resistant Staphylococcus aureus (MRSA), so vancomycin was administered intravenously for 8 weeks. The postoperative course was uneventful. We considered that omental transfer can be very effective in the management of severe mediastinitis, especially that due to an infected pseudoaneurysm or widespread mediastinitis caused by MRSA.

Aged↗
PubMed1995

[Clinical evaluation of safety, pharmacokinetics and dosimetry of the somatostatin analog 111In-DTPA-D-Phe-octreotide--report of the phase 1 study].

The safety, pharmacokinetics and dosimetry of the somatostatin analog 111In-DTPA-D-Phe-octreotide (111In-octreotide) were investigated in four young normal volunteers as phase 1 study in Japan. Neither adverse reactions nor significant changes of vital signs and clinical laboratory data were observed after intravenous injection of 111 MBq of 111In octreotide. The plasma clearance curve consisted of fast and slow exponential components with mean half life of 9.2 minutes and 2.2 hours, respectively. Seventy three percent of the injected dose were excreted in the urine by 24 hours after the injection of 111In-octreotide. With respect to the radiation dose to normal tissue, the most important organs were the urinary bladder, the kidney, the spleen and the liver. The effective dose equivalent was calculated as 3.26 +/- 0.43 mSv/37 MBq (mean +/- s.d.). This phase 1 study demonstrated the safety of scintigraphy with 111In-octreotide.

Adult↗
PubMed1995

[Computed tomography with continuous transport and continuous scanner rotation for laparoscopic cholecystectomy].

We investigated the 58 cases of cholecystolithiasis including 8 cases of choledocholithiasis treated with laparoscopic cholecystectomy. All patients received spiral CT scanning with drip infusion cholangiography (DIC-SCT), and 1.6 patients received endoscopic retrograde cholangiography (ERC), and the detection rates of the gallbladder, the bile duct and the cystic duct were compared. The gallbladder could be seen in 86.2% of cases with DIC-SCT and in 63.8% of cases with conventional DIC. The junction between the cystic duct and the common bile duct could be seen in 18 of 58 cases with DIC and in 49 of 58 cases with DIC-SCT. The DIC-SCT showed significantly superior anatomical details compared with images with conventional DIC. A comparison of DIC, ERC and DIC-SCT revealed that the junction between the cystic duct and the common bile duct could be identified in 14 of 16 cases undergoing ERC, in 13 of 16 cases receiving DIC-SCT and in 4 of 16 cases receiving DIC. Significant differences were noted among DIC-SCT, ERC and conventional DIC. We concluded that DIC-SCT is easy, non-invasive and useful for the preoperative assessment of laparoscopic cholecystectomy and also helpful for avoiding damage to the bile duct.

Adolescent↗
PubMed1995

[A case of posterior fossa hypertrophic pachymeningitis with hydrocephalus].

A 52-year-old woman was admitted to our hospital because of nausea, headache, ataxic gait, and memory disturbance. CT scans and MRI showed a markedly enhanced lesion in the dura mater of the posterior fossa, edema in the right cerebellar hemisphere, occlusion of the transverse sinus, and hydrocephalus, suggesting hypertrophic pachymeningitis. Chronic otitis media and mastoiditis were also noted. Subjective complaints diminished after steroid administration. The patient underwent right suboccipital craniectomy and biopsy. The dura mater was markedly thickened, and the cerebellar surface was edematous. Histological examination revealed the thickened dura mater to be infiltrated by chronic inflammatory cells of forming lymphatic follicles and accompanied by Langhans giant cells. Inflammatory cells were not found in the cerebellar parenchyma, but were present in the subarachnoid space. Acid-fast stain, PAS and Grocott stain were negative. The cause of the hypertrophic pachymeningitis in this patient, may have been related to the chronic otitis media, but the patient's clinical course suggested that it might represent so-called "idiopathic hypertrophic pachymeningitis".

Cranial Fossa, Posterior↗
PubMed1995

Reduction of intermediate density lipoprotein by pravastatin in hemo- and peritoneal dialysis patients.

Elevated plasma intermediate density lipoprotein (IDL) is one of the features of uremic dyslipidemia which is potentially atherogenic. We examined the effects of pravastatin, an HMG-CoA reductase inhibitor, on IDL levels as well as other lipoprotein parameters in 19 uremic patients treated with hemodialysis (HD, n = 11) or continuous ambulatory peritoneal dialysis (CAPD, n = 8). The patients were administered 5 mg/day pravastatin for the initial 4 weeks and 10 mg/day for the subsequent 12 weeks. In the analysis of the total subjects, IDL-cholesterol was reduced by 31% as well as low density lipoprotein (LDL)-cholesterol. Cholesterol in very low density lipoprotein (VLDL) also decreased whereas that in high density lipoprotein (HDL) did not. Significant decrease of serum triglycerides was due mainly to reduced IDL- and LDL-triglycerides. Apolipoprotein (apo) A-I did not change, whereas apo A-II, B, C-II, C-III, E, and B/A-I ratio were significantly lowered. Pravastatin did not affect measured activity of lecithin: cholesterol acyltransferase, post-heparin plasma lipoprotein lipase or hepatic triglyceride lipase. HD and CAPD patients responded almost equally to the treatment. IDL elevation was present independent of serum total cholesterol, and it was lowered by pravastatin even in non-hypercholesterolemic subjects. There was no critical adverse effect besides transient and asymptomatic increase of serum creatine kinase level. We conclude that pravastatin can be a safe and effective approach to the management of dyslipidemia in uremic patients who have an elevated level of IDL.

Apolipoproteins↗
PubMed1995

Quantitative estimation of ideal body weight in uremic patients.

There is no definite way to estimate the ideal body fluid level in uremic patients. We developed a simple method to quantitatively estimate the ideal body weight. Hemofiltration (HF) was performed 9 times in 5 uremic patients. Urea-nitrogen concentration was measured in plasma before and after HF and in total ultrafiltrate mixture. Creatinine concentration was measured in plasma after HF and before the next HF and in urine collected between those two HF therapies. Total body fluid volume, TBF, was obtained, based on urea kinetics principles, as 36.8 +/- 1.8 L after HF assuming that urea is distributed uniformly within total body fluid. Creatinine generation rate, Gcr, was calculated as the sum of urinary creatinine excretion rate, creatinine accumulation rate within body fluids and extra-renal creatinine excretion rate. It is known that solid mass, SM, is related to Gcr and that the TBF to lean body mass (= SM + TBF) ratio is constant under ideal fluid level conditions. Thus, TBF under ideal body fluid level conditions (37.8 +/- 3.0 L), SM (13.7 +/- 1.1 kg) and fat mass (3.7 +/- 2.3 kg) were derived, and finally we found body weight value under ideal fluid level conditions to be 55.1 +/- 4.2 kg. The ideal body weight estimated this way was found to be significantly correlated with the dry weight (54.0 +/- 3.5 kg) determined clinically by conventional means (r = 0.9; p < 0.01); no significant difference was found between these body weight values. Our results suggest that the ideal body weight can be estimated simply by applying both urea and creatinine kinetics principles in uremic patients.

Adult↗
PubMed1995

[A case of infective mitral endocarditis after percutaneous transvenous mitral commissurotomy].

We encountered a case of infective mitral endocarditis (IE) due to Methicillin resistant staphylococcus aureus (MRSA) after percutaneous transvenous mitral commissurotomy (PTMC). A 65-year-old woman underwent PTMC for mitral stenosis. Two days later, she incurred a fever of more than 40 degrees C, and MRSA was detected in her blood culture. Inflammation and renal function deteriorated despite transvenous administration of antibiotics. Transesophageal echocardiogram revealed vegetation at the mitral valve. Mitral valve replacement was performed after diagnosis of IE, and MRSA was identified from the vegetation. The patient improved with the transvenous application of antibiotics including vancomycin hydrochloride. The blood culture became negative and inflammation was suppressed. In view of this case, we consider that IE is a possible complication following PTMC.

Aged↗
PubMed1995

[A construction of a PACS and reporting system linked with the hospital information system in Gunma University Hospital].

A PACS (Picture Archiving and Communication System) and reporting system were introduced into Gunma University Hospital. These systems were linked with Hospital Information System (HIS), enabling us to refer to images, such as those of CR, CT, MRI and scintigraphy, at wards and conference rooms within a reasonable times. Bone scintigraphy and a report on it are illustrated as an example. A standardized protocol for the interface between PACS and the imaging format must be established without delay for the progress of PACS.

Computer Communication Networks↗
PubMed1995

[A case of using continuous double-tapped epidural analgesia for herpes zoster duplex].

A 66-year-old woman developed herpes zoster duplex, which is a rare disease. She had severe pain at the right upper back area and left lower abdominal area. The authors used double-tapped continuous epidural analgesia for this patient. The catheters for the epidural block were placed at the 8th thoracic vertebral level and 2nd lumbar vertebral level. After the start of continuous epidural block, she suffered from nausea, vomited, and felt dizzy. It was evident that these symptoms were caused by local anesthetic toxicity. We emphasize that we must pay attention to the patient who undergoes continuous double-tapped epidural analgesia for pain relief so as not to elicit local anesthetic toxicity.

Aged↗
PubMed1995

[Planning for brachytherapy using a 3D-simulation model].

A 3D-simulation model made with a milling system was applied to HDR-brachytherapy. The 3D-simulation model is used to simulate the 3D-structure of the lesion and the surrounding organs before the actual catheterization for brachytherapy. The first case was recurrent prostatic cancer in a 61-year-old man. The other case was lymph node recurrence of a 71-year-old woman's upper gum cancer. In both cases, the 3D-simulation model was very useful to simulate the 3D-conformation, to plan the treatment process and to avoid the risk accompanying treatment.

Aged↗
PubMed1995

[High dose rate fractionated interstitial radiotherapy for vulvar cancer using traction technique].

A 73-year-old woman with vulvar cancer T2NO was treated with high dose rate fractionated interstitial radiotherapy after 30 Gy of external radiotherapy. Sufficient space to insert 12 needles was made by pulling the vulva out perpendicular to the perineal skin. Four surgical threads were introduced between the vulva and the underlying pubic bones. A pair of custom-made templates were attached sandwiching the vulva pulled out with the threads. Using traction technique 12 stainless needles were easily inserted and replaced by plastic tubes. Forty Gy/10 fractions/six days was delivered, and the tumor has been controlled clinically and histologically so far.

Aged↗